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General NPI Number Information
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NPI Number | 1346755782
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Entity Type | Organization
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Legal Business Name | LIGHTNING THERAPY LLC
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Dates
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Enumeration Date | 12/07/2017
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Last Update Date | 02/04/2020
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Provider Practice Location Address
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Address Line | 11442 LAUREL BROOK CT
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City | RIVERVIEW
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State | FL
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Zip | 33569-2021
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Country | US
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Telephone | 813-957-4041
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Fax |
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Provider Business Mailing Address
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Address Line | 11442 LAUREL BROOK CT
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City | RIVERVIEW
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State | FL
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Zip | 33569-2021
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Country | US
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Telephone | 813-957-4041
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Fax |
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Authorized Official
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Title or Position | CO OWENER
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Name | MR. MICHAEL LAMIANO
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Credential | OT
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Telephone | 813-957-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT11939
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | OT11940
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License Number State | FL
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